Antioxidants and Cardiovascular Disease: Why Do We Still Not Have the Answers?

In this issue, Jha and colleagues [1] provide an excellent review of the published prospective epidemiologic studies and randomized, controlled trials with more than 100 patients that address the possibility that supplementary antioxidant vitamins (E, C, and β-carotene) prevent cardiovascular disease and reduce overall mortality rates. The question is important because it is entirely possible that reducing cholesterol levels, cigarette smoking, and blood pressure; increasing exercise; and controlling diabetes have achieved all that they will achieve except through greater compliance, and it may be time to explore other channels of opportunity. As Jha and colleagues [1] point out, suspicion of the efficacy of antioxidants has been around for a long time. Why do we still not know whether they are effective?

The answer probably lies in the clinical technologies that have …